Effects of Task-Specific Locomotor and Strength Training in Adults Who Were Ambulatory After Stroke: Results of the STEPS Randomized Clinical Trial
Open Access
- 25 September 2007
- journal article
- research article
- Published by Oxford University Press (OUP) in PTJ: Physical Therapy & Rehabilitation Journal
- Vol. 87 (12), 1580-1602
- https://doi.org/10.2522/ptj.20060310
Abstract
Background and Purpose: A phase II, single-blinded, randomized clinical trial was conducted to determine the effects of combined task-specific and lower-extremity (LE) strength training to improve walking ability after stroke. Subjects: The participants were 80 adults who were ambulatory 4 months to 5 years after a unilateral stroke. Method: The exercise interventions consisted of body-weight–supported treadmill training (BWSTT), limb-loaded resistive leg cycling (CYCLE), LE muscle-specific progressive-resistive exercise (LE-EX), and upper-extremity ergometry (UE-EX). After baseline assessments, participants were randomly assigned to a combined exercise program that included an exercise pair. The exercise pairs were: BWSTT/UE-EX, CYCLE/UE-EX, BWSTT/CYCLE, and BWSTT/LE-EX. Exercise sessions were 4 times per week for 6 weeks (total of 24 sessions), with exercise type completed on alternate days. Outcomes were self-selected walking speed, fast walking speed, and 6-minute walk distance measured before and after intervention and at a 6-month follow-up. Results: The BWSTT/UE-EX group had significantly greater walking speed increases compared with the CYCLE/UE-EX group; both groups improved in distance walked. All BWSTT groups increased walking speed and distance whether BWSTT was combined with LE strength training or not. Discussion and Conclusion: After chronic stroke, task-specific training during treadmill walking with body-weight support is more effective in improving walking speed and maintaining these gains at 6 months than resisted leg cycling alone. Consistent with the overtraining literature, LE strength training alternated daily with BWSTT walking did not provide an added benefit to walking outcomes.Keywords
This publication has 51 references indexed in Scilit:
- Especial Skills: Their Emergence With Massive Amounts of Practice.Journal of Experimental Psychology: Human Perception and Performance, 2005
- Exercise programs for older men: mode and intensity to induce the highest possible health-related benefitsPreventive Medicine, 2004
- Effects of Resistance Training on Older AdultsSports Medicine, 2004
- Randomized Clinical Trial of Therapeutic Exercise in Subacute StrokeStroke, 2003
- Use of cluster analysis for gait pattern classification of patients in the early and late recovery phases following strokeGait & Posture, 2003
- Physical and Social Functioning After StrokeStroke, 2003
- Treadmill Training With Partial Body Weight Support and an Electromechanical Gait Trainer for Restoration of Gait in Subacute Stroke PatientsStroke, 2002
- Speed-Dependent Treadmill Training in Ambulatory Hemiparetic Stroke PatientsStroke, 2002
- Classification of Walking Handicap in the Stroke PopulationStroke, 1995
- Task-specific physical therapy for optimization of gait recovery in acute stroke patientsArchives of Physical Medicine and Rehabilitation, 1993